Organization Active NPI

Tri-State Ambulance, Inc.

  • Land Ambulance
  • La Crosse, WI
National Provider Identifier
1659402600
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
6011353 Issued in WI
Legal business name
TRI-STATE AMBULANCE, INC.
Practice address
235 Causeway Blvd
La Crosse, WI 54603-3119
Phone
(608) 782-2282
Fax
(608) 782-4522
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tom Tornstrom
Title
Director
Phone
(608) 782-2282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 6011353 WI Primary

Addresses

Primary practice location

235 Causeway Blvd
La Crosse, WI 54603-3119

Mailing address

235 Causeway Blvd
La Crosse, WI 54603-3119
Phone (608) 782-2282

Other identifiers 3

IdentifierTypeStateIssuer
0554113MedicaidIA
41359100MedicaidWI
263067200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090113000224 WI Part B Supplier - Ambulance Service Supplier 5698838951 Practice locations: Holmen, WI; La Crosse, WI; Viroqua, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0931184Tri-State Ambulance Inc235 Causeway Blvd, La Crosse, WI 54603Certificate of waiverJul 23, 2027
52D2032715Tri-State Regional Ambulance235 Causeway Blvd, La Crosse, WI 54603Certificate of waiverNov 13, 2027

National Provider Directory

National Provider Directory

Locations

221 Buchner Pl
La Crosse, WI 54603

2827 26th St S
La Crosse, WI 54601
Phone (608) 788-2322

110 Brendal Ln
#A
Viroqua, WI 54665
Phone (608) 637-8639

126 W Jefferson St
Viroqua, WI 54665
Phone (608) 637-8639

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1659402600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 CAUSEWAY BLVD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546033119",
            "telephone_number": "608-782-2282",
            "fax_number": "608-782-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 CAUSEWAY BLVD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546033119",
            "telephone_number": "608-782-2282",
            "fax_number": "608-782-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE AMBULANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "TORNSTROM",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-782-2282"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6011353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0554113",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41359100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263067200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.